SUNDAY, July 14, 2019 (HealthDay News) — Swimming lessons can lower the risk of drowning, but black kids often miss out on learning this lifesaving skill, a leading pediatricians group says.
“Everyone should have the opportunity to learn to swim,” said Dr. Kyle Yasuda, president of the American Academy of Pediatrics (AAP).
“This is an essential life skill for children, teens and adults. It’s an important part of the ‘layers of protection’ that families and communities can put in place to protect children and teens around water,” Yasuda said in an AAP news release.
Not everyone has the same access to swimming lessons. Historically, black Americans have faced barriers to learning to swim, and black teen boys have the highest drowning risk of any age group, according to the academy.
Rates of drowning among children aged 11 to 12 are 10 times higher for black kids than for whites, according to the U.S. Centers for Disease Control and Prevention.
According to Dr. Nia Heard-Garris, “This is a problem we can solve.” She is chair of the AAP Section on Minority Health, Equity and Inclusion.
“Some communities have created innovative solutions to provide free or low-cost swim lessons, and others have developed culturally sensitive lessons, and lessons for children with developmental disabilities or special health care needs. All children should have access to these potentially lifesaving skills,” Heard-Garris said.
In 2017, nearly 1,000 children in the United States died of drowning, the leading cause of injury-related death among children aged 1 to 4.
Overall, black children have the highest drowning fatality rates, followed by American Indian/Alaskan natives, whites, Asian American/Pacific Islanders, and Hispanics.
Dr. Benjamin Hoffman is chair of the AAP Council on Injury, Violence & Poison Prevention. He said, “Drowning is fast, silent, and can happen even when it is not swim time. It happens to real families, families with good, attentive parents who never thought it could happen to them. I can’t emphasize enough how important it is to have many layers of protection to prevent drowning.”
Along with learning to swim, those layers of protection include close and constant supervision of children when they’re in and around water, pool fencing, learning CPR, and wearing life jackets when in open water or on watercraft, the AAP says.
For Kids With Rare Condition, 'Restricted' Diets Can Turn Dangerous By Serena Gordon HealthDay Reporter
THURSDAY, July 11, 2019 (HealthDay News) — Two young patients — one 3 and the other 13 — have a rare condition that calls for a highly restricted diet. Both have so much trouble eating that they developed an eating disorder and required feeding tubes, a new report shows.
Such is the fate of some of those with eosinophilic esophagitis (EOE), a chronic inflammatory disease that affects the tube running from the mouth to the stomach. A specific type of white blood cell (eosinophil) accumulates in the esophagus, causing difficulty swallowing, pain and vomiting. Having the condition can mean eliminating milk, soy, wheat, eggs, fish and nuts from the diet.
But following such an intense eating regimen can take its toll.
“Many people haven’t heard of this condition, but it’s rising at an alarming rate here [in Utah],” said study author Dr. Jacob Robson, an assistant professor of pediatrics at the University of Utah.
Robson explained that because there’s no specific test to know which foods are causing someone’s symptoms in EOE, the six-food elimination diet is one of the treatments.
But, he acknowledged, “The diet doesn’t leave you with a lot of foods. You have to work with an expert dietitian. It’s really hard.”
Dr. Wendy Book, president of American Partnership for Eosinophilic Disorders (APFED), said that most people with EOE can be “successfully treated with the removal of only a few proteins from their diet, most commonly milk.”
She added that for a small number of people with EOE, the dietary restrictions can be numerous.
Book said the condition is relatively rare, affecting up to 0.1% of people in the United States.
The new study focused on two children with EOE on restrictive diets. They developed signs of avoidant or restrictive food disorder (ARFID), a newly recognized type of eating disorder. In a past study, Robson and his colleagues identified more than 1,000 cases of EOE diagnosed in the past five years. Of those, 44 showed signs of the new eating disorder.
The first example in the new study was a child diagnosed at 3 years old. His case was so severe he eventually needed to be fed a special formula through a feeding tube. When he reached school age, he wanted to be able to eat like his classmates.
With medications and cognitive behavioral therapy, he was able to start eating a restricted diet again. But, he wasn’t eating enough to maintain his weight. He said he wasn’t interested in eating, had an aversion to certain textures and tastes, and felt full very quickly. Because of continued weight loss, he had to have supplemental feedings through a feeding tube to maintain his weight.
The second case was diagnosed at 13. He wasn’t able to eat wheat, eggs or nuts due to EOE. He also couldn’t eat apples, tomatoes and root vegetables due to oral allergy syndrome. In his later teens, the young man had lost significant weight. He expressed concern about not being able to eat enough to maintain his weight, and had to have supplemental nutrition through a feeding tube.
He had cognitive behavioral therapy (a psychological treatment), and was also treated for his overall anxiety (not just food-related) with an antidepressant. Eventually he was able to start eating a wide variety of foods again.
Robson said anyone living with a medically restrictive diet or their loved ones should keep an eye out for a very picky eating pattern — only eating a few foods, or not eating a lot and just grazing on a few bites at a time.
Book said that if parents have concerns, they should let their child’s health care provider know right away. “Do not be afraid to ask for help,” she said.
Both experts recommend working with a dietitian familiar with your child’s condition.
Book also said it’s important to approach the restrictions as a way to better health.
“Try to avoid negative terms such as ‘cheating’ when discussing diet, and instead focus on the positive: These dietary changes can make them feel better,” Book said.
She also recommended involving kids in menu planning, shopping and cooking. And, during holidays or special occasions where people tend to focus on foods, Book said it helps to plan special activities not based on meals, like going to the movies or a family camping trip.
The study was published recently in the Journal of Pediatric Gastroenterology and Nutrition.
SOURCES: Jacob Robson, M.D., assistant professor, pediatrics, division of pediatric gastroenterology, hepatology and nutrition, University of Utah; Wendy Book, M.D., president, American Partnership for Eosinophilic Disorders; April 2019, Journal of Pediatric Gastroenterology and Nutrition
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Poor Social Life Could Spell Trouble for Older Women's Bones
WEDNESDAY, July 10, 2019 (HealthDay News) — A lack of positive connections with others may do more than make older women lonely, with new research suggesting it can also weaken their bones.
In a long-term study of more than 11,000 postmenopausal women in the United States, lower bone mineral density was associated with higher “social strain,” a measure of negative social interactions and relationships. Weaker bones were also tied to lower levels of social activity.
Higher social strain was associated with greater bone mineral loss of the total hip, lumbar spine (lower back) and femoral neck (just below the ball of the ball-and-socket hip joint).
The women’s social strain scores ranged from 4 to 20, with higher scores indicating more strain. Each point higher was associated with 0.08% greater loss of femoral neck bone mineral density, 0.11% greater loss of total hip bone mineral density and 0.07% greater loss of lumbar spine bone mineral density.
Lower social activity was associated with greater bone loss at the total hip and femoral neck, according to the study published July 9 in the Journal of Epidemiology & Community Health.
The associations between bone mineral density and social strain and social activity were found after the researchers adjusted for age, education, existing health conditions, weight, smoking status, alcohol use, hormone therapy use, age at menopause, physical activity and history of fracture after age 55.
Because this was an observational study, it can’t prove that poor social connections actually cause bone mineral density loss, the authors noted.
However, the findings show that “bone loss is among the physiological stress responses more strongly related to the quality of social relationships than quantity,” according to Shawna Follis, from the University of Arizona’s department of epidemiology and biostatistics, and colleagues.
The researchers also pointed to prior studies, which have suggested that factors such as major stressful events and lower levels of optimism, life satisfaction and education, may be associated with fractures.
Based on the findings, community-based efforts to help older women have healthy, active social lives might end up helping their bone health, too, the study authors said.
More Americans Are Eating Whole Grains, But Intake Still Too Low By E.J. Mundell HealthDay Reporter
Latest Nutrition, Food & Recipes News
TUESDAY, July 9, 2019 (HealthDay News) — The popularity of heart-healthy whole grains is on the rise among Americans, but levels are still far below those recommended by nutritionists, a new report shows.
Overall, whole grains — products with 100% whole grains or made with whole grain flour — made up almost 16% of total grain intake on any given day in 2016.
That’s a rise from the 12.6% level recorded in 2006, noted researchers led by Namanjeet Ahluwalia, from the U.S. Centers for Disease Control and Prevention.
But they said that “the magnitude of this increase was small” and still falls far short of recommended intake levels.
Rates of intake appeared to rise with increasing age and income, the study found.
It “shows the good and the bad,” said one nutritionist who reviewed the new report.
“The good is that Americans are moving in the right direction by eating more whole grain products, especially women and those 60 years old and older,” said Liz Weinandy, a registered dietitian at Ohio State University Wexner Medical Center in Columbus.
“The bad,” she said, “is that it is recommended that at least half of all grains eaten be whole grain and even in the age group eating the most whole grains — those 60 and over — only about 20% of grains eaten are whole grain.”
Dietary experts have long recommended that Americans make the switch from processed, refined grains — the type found in many white breads, pastas and bakery fare — to high-fiber whole grains.
“Whole grains contain greater amounts of fiber, vitamins, minerals and phytochemicals compared with refined grains,” Ahluwalia and her team noted. Because of this, “a higher intake of whole grains is linked with a lower risk of cardiovascular disease, cancer and mortality,” they explained.
The new data was taken from federal health surveys conducted between 2003 and 2016 among of Americans aged 20 and older. It found that when it comes to a preference for whole grains, age, gender and income matter.
Women were more likely than men to go for whole grains, at 16.7% and 14.8% of total daily grain intake, respectively. And intake rates rose from 12.9% among people in their 20s and 30s to a high of 19.7% for those age 60 and over, the report found.
And while the intake level of people near or below the poverty line was just 12%, it rose to almost 18% for more affluent people with incomes more than four times the federal poverty level.
According to Weinandy, cost shouldn’t be an issue.
“Compared to refined grains, whole grains are not expensive and not much different in how we cook or choose them, so we should be picking a lot more of these as an easy way to help us live longer,” she said.
Katrina Hartog is a registered dietitian and clinical nutrition manager at Lenox Hill Hospital in New York City. Reviewing the findings, she said that “as a health professional, I will use this information to continue to encourage and promote whole grain versus refined grain intake with my clients and patients.”
Hartog said the key to upping intake further may lie in “developing targeted community nutrition programs for specific population groups.”
The report was published July 9 by the CDC as a National Center for Health Statistics Data Brief.
SOURCES: Katrina Hartog, R.D., C.D.N., clinical nutrition manager, Lenox Hill Hospital, New York City; Liz Weinandy, R.D., Ohio State University Wexner Medical Center, Columbus; National Center for Health Statistics Data Brief, July 9, 2019
According to the USDA, there is no difference between a “portion” and a “serving.” See Answer
In-Hospital Cardiac Arrests May Be a 'Major Public Health Problem'
TUESDAY, July 9, 2019 (HealthDay News) — Many more U.S. hospital patients suffer cardiac arrest than previously thought, a new study reveals.
Cardiac arrest occurs when the heart stops beating. It differs from a heart attack, in which blood flow to the heart is blocked.
This new analysis concluded that there are about 38% more adult cases and 18% more cases in children each year than estimated in a 2011 report.
“Our findings illustrate a concerning trend in U.S. hospitals, and show that cardiac arrest is a major public health problem,” said study co-author Dr. Lars Andersen, an associate professor at Aarhus University in Denmark.
The findings stem from American Hospital Association survey data. They were published July 9 in the journal Circulation: Cardiovascular Quality and Outcomes.
“Previous incidence estimates may no longer reflect the current public health burden of cardiac arrest in hospitalized patients across the U.S.,” Andersen said in a journal news release. He oversaw the study as a visiting researcher at Beth Israel Deaconess Medical Center in Boston.
Using recent U.S. hospital data, Andersen’s team estimated there are about 292,000 adult in-hospital cardiac arrests and 15,200 child in-hospital events each year.
That’s up from the 2011 estimates of 211,000 adult cases and 6,000 in children.
“Unfortunately, the data does not provide an explanation for the increase in adult in-hospital cardiac arrest, but it is likely due to many factors and may reflect an increase in actual events or in the reporting of cases over time,” Andersen said.
For example, the investigators believe the hike in pediatric cases is likely due to expanded reporting.
Andersen noted that life-support training programs tend to emphasize out-of-hospital resuscitation. The new findings suggest these programs should be expanded to include potential in-hospital responders, he said.
“It is also important to note that end-of-life discussions and decisions are crucial in order to avoid attempts at resuscitation in patients where it is likely futile or against a patient’s wishes,” Andersen said.